网片改良植入治疗重度盆底器官脱垂的临床效果分析  

Clinical effect of improved mesh in the treatment of severe pelvic organ prolapse

作　　者：郭静[1] 陈英超[1] 冯博 杨丹[1] Guo Jing;Chen Yingchao;Feng Bo;Yang Dan(Department of Obstetrics and Gynecology,Harbin First Hospital,Harbin 150000,China)

机构地区：[1]黑龙江省哈尔滨市第一医院妇产科,150000

出　　处：《中国综合临床》2019年第1期59-62,共4页Clinical Medicine of China

摘　　要：目的探讨盆底网片改良植入治疗重度盆底器官脱垂的临床效果。方法选取2016年1月至2018年4月黑龙江省哈尔滨市第一医院收治的重度盆腔器官脱垂患者84例,计算机随机分为观察组与对照组各42例。对照组采用传统的盆底重建术,即前盆腔与后盆腔各植入一张网片承托盆腔器官,观察组只用一张原有的前盆腔网片,通过改变穿刺点的进出位置,从而完成全盆底修复。比较两种手术方式的治疗效果,包括全身一般情况、围手术期、手术期及随访情况。结果观察组的术中出血量明显低于对照组[(65.32±20.39) ml与(86.52±30.23) ml],差异有统计学意义(t=4.56,P<0.05),观察组手术时间低于对照组[(40.35±12.41) min与(57.83±17.54) min],差异有统计学意义(t=6.56,P<0.05),观察组治疗费用明显低于对照组[(10 600±1 012)元与(20 200±1 123)元],差异有统计学意义(t=25.38,P<0.05)。术后随访1年,观察组患者出现网片侵蚀1例(2.4%,1/42),2例(4.8%,2/42)性交不适感,复发2例(4.8%,2/42)。对照组中,网片侵蚀3例(7.1%,3/42),4例性交不适感(9.5%,4/42),复发3例(7.1%,3/42),观察组网片引起的并发症明显低于对照组[2.4%(1/42)与7.1%(3/42),4.8%(2/42)与9.5%(4/42)](χ^2值分别为3.98、3.46,P均<0.05)。而两者的尿管放置时间、术后排气时间、复发率比较差异均无统计学意义(统计值分别为0.08、0.48、0.05,P均>0.05)。结论盆底网片改良植入术,作为更加微创的新式手术方式,减少了网片的植入及手术创伤,并发症少,术后恢复更快,节约了医疗费用,临床应用前景广阔。Objective To discuss the clinical effect of improved pelvic floor mesh implantation in the treatment of severe pelvic organ prolapse.Methods From January 2016 to April 2018, eighty-four patients with severe pelvic organ prolapse admitted to Harbin First Hospital were randomly divided into observation group and control group with 42 cases in each group.The control group was treated with traditional pelvic floor reconstruction, which used two meshes to reconstruct front and back of pelvic cavity.42 cases of the observation group were treated with improved mesh-augmented vaginal reconstructive surgery, which used only one mesh to reconstruct total pelvic reconstruction by changing the location of puncture.The therapeutic effects of the two surgical methods were compared, including general condition of the whole body, perioperative period, operative period and follow-up.Results The amount of blood loss in the observation group were significantly lower than that in the control group((65.32±20.39) ml vs.(86.52±30.23) ml), and the difference was statistically significant (t=4.56, P<0.05). The average operation time in the observation group were significantly lower than that in the control group ((40.35±12.41) min vs.(57.83±17.54) min), and the difference was statistically significant (t=6.56, P<0.05). The medical fees in the observation group were significantly lower than that in the control group ((10 600±1 012)yuan vs.(20 200±1 123)yuan), and the difference was statistically significant (t=25.38, P<0.05). After one year follow-up, there were 1 case (2.4%, 1/42) of mesh erosion, 2 cases (4.8%, 2/42) of sexual discomfort and 2 cases (4.8%) of recurrence in the observation group.In the control group, there were 3 cases (7.1%) of mesh erosion, 4 cases (9.5%) of sexual discomfort and 3 cases (7.1%) of recurrence.The complications caused by mesh in the observation group were significantly lower than those in the control group (2.4% (1/42) vs.7.1% (3/42), 4.8% (2/42) vs.9.5% (4/42)) (χ^2=3.98, 3.46, P<0.05). There was

关 键 词：盆底重建术 重度盆底器官脱垂 网片改良植入术 治疗效果 

分 类 号：R713[医药卫生—妇产科学]